VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN

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DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Set Number Concept Search Statement additional OR several OR concomitant) 42 'prescription drug'/exp AND 'non prescription drug'/exp OR 'polypharmacy'/exp 43 Combine medicine 38 OR 39 OR 40 OR 41 sets 44 'treatment outcome'/de OR 'side effect'/de OR 'adverse drug reaction'/exp OR 'patient safety'/exp OR safety OR effectiveness OR effective OR outcome* 45 Combine with 42 AND 43 outcomes 46 Combine with chronic pain and LTOT 11 AND 45 47 Risk mitigation for addiction (KQ7) 'opiate addiction'/exp OR ‘substance abuse’/exp OR ‘drug monitoring’/exp OR ‘prescription drug diversion’/exp OR ((addict* OR abuse OR misuse OR diversion OR divert) AND (opi* OR oxymorphone OR tapentadol OR methadone OR fentanyl OR hydrocodone OR oxycodone OR codeine OR morphine OR hydromorphone OR tramadol)) 48 urin* NEXT/7 (screen* OR test* OR detect* OR anal* OR monitor*) OR ‘urinalysis’/exp 49 pill NEXT/2 count OR 'call back' OR database OR query OR compliance OR contract* OR agreement OR consent OR recall OR surveillance OR call-back OR monitor* OR naloxone NEXT/2 rescue 50 'patient compliance'/exp OR (patient:ab,ti AND (compliance:ab,ti OR comply:ab,ti)) 51 'patient education'/exp OR patient NEXT/3 (aware* OR educat*) 52 (office OR doctor OR primary) NEXT/3 (visit* OR appointment* OR check*) 53 'contracts'/exp OR opi* NEXT/5 (contract OR contracts OR agreement) 54 Risk* NEXT/7 (mitigate* OR reduc*) OR ‘risk’/exp OR ‘risk reduction’/exp OR ‘risk evaluation and mitigation strategy’ OR ‘naloxone’/exp OR naloxone OR rescue OR precaution* 55 Combine risk 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 mitigation strategies 56 Combine with chronic pain and LTOT 11 AND 55 57 Treatment of OUD (KQ8) addict* OR abuse OR misuse OR disorder AND (opi* OR oxymorphone OR tapentadol OR methadone OR fentanyl OR hydrocodone OR oxycodone OR codeine OR morphine OR hydromorphone OR tramadol) OR ‘opiate use disorder’ 58 'opiate addiction'/exp OR 'analgesic agent abuse'/exp OR ('drug abuse'/exp OR 'drug dependence'/exp OR 'narcotic dependence'/exp OR 'addiction'/exp OR aberrant:ti OR aberrant:ab AND ('narcotic analgesic agent'/exp OR 'opiates'/exp OR opioid* OR oxymorphone OR tapentadol OR methadone OR fentanyl OR hydrocodone OR oxycodone OR codeine OR morphine OR hydromorphone OR tramadol OR analgesic*)) 59 'psychotherapy'/exp OR 'cognitive therapy'/exp OR 'counseling'/exp OR 'acceptance and commitment therapy'/exp OR 'support group'/exp OR 'motivational interviewing'/exp 60 counsel OR counseling OR (cognitive OR contingency OR drug OR behavioral OR motivational) NEAR/2 (counseling OR therapy) OR 'contingency management' OR motivation* NEAR/1 interview* OR buprenorphine OR naloxone OR February 2017 Page 174 of 192
DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Set Number Concept Search Statement methadone 61 Combine opioid 57 OR 58 addiction set 62 Combine counsel set 59 OR 60 63 Combine with chronic 11 AND 61 AND 62 pain and LTOT 64 Tapering (KQ9) 'pain management'/exp OR 'analgesia'/exp AND ('drug administration'/exp OR 'clinical protocol'/exp) 65 ‘dose response’/exp OR ((dose OR dosing) AND (protocol* OR administration OR plan* OR schedule* OR strategy OR strategies)) 66 (taper* OR decrease* OR reduc* OR adjust* OR titrat* OR dosing OR dose*) AND (protocol* OR administration OR plan* OR schedule* OR strategy OR strategies) 67 Combine tapering sets 64 OR 65 OR 66 68 Combine with chronic 11 AND 67 pain and LTOT 69 Combine all final sets 15 OR 22 OR 28 OR 38 OR 46 OR 56 OR 63 OR 68 70 Apply limits 69 AND [2009-2016]/py AND [English]/lim AND [humans]/lim 71 Apply unwanted publication types 70 NOT ('conference abstract'/it OR 'conference paper'/it OR 'editorial'/it OR 'letter'/it OR 'note'/it OR 'short survey'/it) 72 Apply trials hedge 71 AND (random*:ab,ti OR trial* OR control* OR cohort OR compar*:ab,ti OR prospective OR retrospective OR series OR review* OR study OR studies OR method* OR analysis OR systematic*:ab,ti) 73 71 AND ('clinical trial'/exp OR 'clinical trial (topic)'/exp OR 'longitudinal study'/exp OR 'major clinical study'/exp OR 'prospective study'/exp OR 'retrospective study'/exp OR 'controlled clinical trial'/exp OR 'controlled clinical trial (topic)'/exp OR 'randomized controlled trial'/exp OR ‘randomized controlled trial’/de OR 'comparative study'/exp OR 'methodology'/exp) 74 71 AND (‘meta analysis’/de OR 'meta analysis (topic)'/exp OR 'meta analysis'/exp OR 'outcomes research'/exp OR 'systematic review'/exp OR 'systematic review (topic)'/exp OR ‘systematic review’/de OR 'meta? analysis':ab,ti OR 'systematic review':ab,ti) 75 Combine 72 OR 73 OR 74 EMBASE.com Syntax: * (within or following a term) = truncation character (wildcard) :ab = limit to abstract :ab,ti = limit to abstract and title NEAR/n = search terms within a specified number (n) of words from each other in any order /exp = “explodes” controlled vocabulary term (e.g., expands search to all more specific related terms in the vocabulary’s hierarchy) :it. = limit to publication type :ti. = limit to title February 2017 Page 175 of 192
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VA/DoD CLINICAL PRACTICE GUIDELINE
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VA/DoD Clinical Practice Guideline
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Appendix D: Drug Tables A. Short-ac
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Short-Acting Opioid Initial Oral Do
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Short-Acting Opioid Initial Oral Do
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Short-Acting Opioid Tramadol (alone
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Long-Acting/ER Opioids 1 Buprenorph
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Long-Acting/ER Opioids 1 Hydrocodon
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Long-Acting/ER Opioids 1 Initial Do
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3 CYP-3A4 inhibiting agents include
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VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN

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